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Personal Information

Appointment Information

Type of appointment

Waiting Time

Was the waiting time acceptable to you?

Overall Cleanliness

0123456789Very Good
0123456789Very CleanNA
0123456789Very Good

Staff & Reception

0123456789Very Friendly
0123456789Very Helpful
Were your interactions with the staff satisfactory?


0123456789Very Well
Were your questions and concerns addressed?


Was the treatment or procedure explained to you in a way that you could understand?
Did you feel comfortable during the treatment or procedure?

Appointment Scheduling

0123456789Very Easy
Were you able to get an appointment within a reasonable timeframe?

Overall Satisfaction

0123456789Very Satisfied
0123456789Very Likely